Findings from the OPTImal CArdiac REhabilitation (OPTICARE)
trial presented at the ESC Congress 2016 show that enhanced cardiac rehabilitation (CR) programmes that include a year of group or personal lifestyle and fitness coaching did not improve cardiovascular risk scores more as compared to a standard 3-month programme in
patients recovering from a heart attack.

The study compared 3 different CR programmes. The standard programme (CR-only) involved 3 months of bi-weekly supervised exercise and educational sessions; the standard CR plus (CR+G) included an additional 9 months of group sessions on lifestyle and fitness training; and the sandard CR plus (CR+T) included an additional 9 months of personal telephone coaching on lifestyle. Assessment was made on the basis of the Systematic COronary Risk Evaluation (SCORE) - a 10-year cardiovascular
mortality risk score based on 3 modifiable risk factors: systolic blood
pressure; total cholesterol; and smoking behavior.

Lead investigator Ron van Domburg, PhD, from Erasmus Medical Center
Rotterdam, the Netherlands, explained that the enhanced protocol did not show any greater improvement in parameters such as blood pressure, BMI, cholesterol or waist circumference but the findings do suggest that patients who stick with the enhanced programme are happier, healthier and more active as compared to those in the regular programme.

No differences between the SCORE outcomes were observed between the three groups. Compliance to the enhanced programmes was lower - 57 percent for the CR+T progamme and 61 percent for the CR+G programme as compared to 83 percent for the standard programme. Smoking cessation and total
cholesterol were significantly better in the CR+G compared with the
CR-only group. Patients in the enhanced programmes had higher health-related quality
of life compared to patients in the standard CR program. CR+G patients
were also less anxious.

“Adaptation of a healthy lifestyle is important, since this can
directly impact cardiovascular mortality and several chronic diseases,
and we think that perhaps a longer CR program may help to solidify these
types of changes in heart attack patients,” said Prof van Domburg.“Using accelerometers in patients over 7 days we also found that the
CR+G patients walked significantly more steps per day than the standard
CR group. Unfortunately, this was not translated into lower blood
pressure or lower BMI.”

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